For a salad dressing ingredient, apple cider vinegar sure gets a lot of credit. This vinegar, which is made from fermented apple juice, has long enjoyed a sunny reputation as a health tonic.
Now it seems the extolment of apple cider vinegar, or ACV, is picking up steam. It’s the latest ingredient being added to prebiotic sodas like Poppi and other canned drinks that tout digestive health benefits. Some claim ACV is a prebiotic, others claim it’s a probiotic. It’s neither.
Popularity of Apple Cider Vinegar
Cider vinegar is also showing up in powdered drink mixes, jars of honey and shots with cayenne, turmeric and ginger. ACV gummies and other supplements are popular offerings at health food stores and heavily promoted online.
Celebrities are sharing how they routinely start their day with a spoonful of ACV – either as a shot or mixed with water.
And there’s an onslaught of books promoting ACV detox cleanses and praising the benefits of this “healing elixir,” claiming it can do everything from cure diabetes and melt fat to kill cancer cells and reverse arthritis.
One of the first books was written by the late Paul C. Bragg, a naturopath who began selling raw, unpasteurized ACV at his Hollywood health store in 1912. That’s where he first distributed his book “Apple Cider Vinegar: Miracle Health System.”
His vinegar is still sold today and is one of the biggest brands of raw, unfiltered ACV with “the mother,” the murky cloud that floats around in the bottle. This is a mixture of yeast and bacteria as a result of the vinegar’s fermentation process.
Even though many of the claims are overstated or flat out wrong, some scientific studies have been conducted on ACV, and the results show some promise. Yet it isn’t clear whether these benefits are specific to ACV or are due to acetic acid, which is found in any vinegar.
Here’s a look at the common myths about ACV and the potential benefits supported by scientific evidence.
Is Apple Cider Vinegar a Probiotic?
Apple cider vinegar is a fermented product, but it does not contain probiotics – even the raw, unpasteurized versions that contain “the mother.” As I’ve written about before, not all fermented products are probiotics, even those with live and active cultures. Probiotics are live microbes with a demonstrated health benefit, and must be at a defined level that survives the journey in our digestive tract, according to the International Scientific Association for Probiotics and Prebiotics. ACV does not live up to that scientific definition. Buy the raw, unfiltered ACV if you want the live microbes and prefer the more appley taste compared to the clear filtered varieties, but don’t mistake it for a probiotic.
Not only is ACV often mistakenly referred to as a probiotic food, but now products also tout the vinegar as a prebiotic – the fuel for probiotic bacteria. That’s also not true, according to Robert Hutkins, professor of food science and technology at the University of Nebraska-Lincoln and one of the country’s leading experts on prebiotics. “It is mainly acetic acid, with trace amounts of polyphenolics that may contribute color and flavor, but there will be little if any pectin or other carbohydrates,” he says.
Is Apple Cider Vinegar Nutritious?
Some articles and books refer to the many nutrients in ACV, including vitamin C, thiamin, riboflavin, folate, potassium, iron, calcium and magnesium. The amounts are so negligible that a tablespoon serving provides 0% of the daily value. Of all these nutrients, the potassium content is the highest, yet a serving provides a mere 11 mg of the mineral. Compare that to a banana with about 400 mg of potassium. You’d need to consume 1 cup of apple cider vinegar to get 2% of the daily value, which is considered a poor source.
In addition, while apples are packed with pectin, there’s little or no pectin in ACV
ACV and Blood Sugar Management
While far from a cure for diabetes, ACV has been shown to have a positive effect on blood sugar levels. Carol Johnston, a professor of nutrition at Arizona State University, has conducted multiple studies on cider vinegar. Her research suggests daily cider vinegar (1 to 2 tablespoons twice a day for 12 weeks) can reduce blood sugar levels and A1c values – the blood marker used to monitor blood sugar management in individuals with Type 2 diabetes.
However, the benefits were only observed after eating a high-carbohydrate meal, such as a bagel and orange juice. Johnston suspects the acetic acid in vinegar interferes with the enzymes that digest carbohydrates. So the simple carbohydrates pass through without stopping, similar to fiber.
“A limitation is that most of the published trials on vinegar have small sample sizes – however, nearly all the trials have shown this benefit in diverse samples of individuals worldwide,” she says.
Since all vinegars contain acetic acid, Johnston says any vinegar would have the same anti-glycemic response. Vinegar is not recommended for those with Type 1 diabetes taking insulin because it may reduce blood glucose to dangerously low levels, she adds.
Apple Cider Vinegar for Weight Loss
Some research has been conducted on the effects of apple cider vinegar on weight loss, yet findings are inconsistent. One Swedish study found that consuming ACV with a high-carbohydrate meal led to increased feelings of fullness, which may help you consume fewer calories throughout the day.
The most cited study was conducted with 175 overweight Japanese subjects who were given 1 or 2 tablespoons of vinegar daily or no vinegar at all. After 12 weeks, those who consumed vinegar had a modest weight loss of 3 to 4 pounds.
This small amount of weight loss may not satisfy individuals who are actively trying to lose weight, says Johnston. A greater degree of weight loss can be achieved by eating smaller portion sizes and reducing intake of fast foods and fried foods, she adds.
“There is a theoretical basis for weight reduction with vinegar intake, but more research is needed to ascertain if this modest reduction in weight loss is continuous and sustained,” she says. “I have not observed significant weight loss in our 12-week trials.”
Can ACV Reduce Blood Cholesterol?
In a meta-analysis of nine randomized clinical trials, apple cider vinegar was shown to significantly reduce total cholesterol. One of the small studies included in the review found that taking ACV every day for 12 weeks, combined with a reduced-calorie diet, lowered total cholesterol and triglyceride levels and led to improvements in HDL (‘good’) cholesterol levels.
While these results may be promising, there are other dietary changes recommended by the American Heart Association that can have an even bigger impact on cholesterol levels.
“Apple cider vinegar can be part of a heart-healthy diet, but it’s important not to isolate one food or ingredient,” says Penny M. Kris-Etherton, the Evan Pugh University Professor of Nutritional Sciences at Penn State University and a volunteer for the American Heart Association. Kris-Etherton is also a member of the U.S. News Best Diets expert panel.
“It’s not just about apple cider vinegar as an ingredient, it’s what is eaten alongside it,” she says. “Eating apple cider vinegar with foods high in saturated fat is different than eating apple cider vinegar as part of dressing on a salad full of leafy greens, lean protein and other vegetables. What is important is the total dietary pattern, which certainly can include ACV, that can significantly affect major risk factors for cardiovascular disease.”
Risks of Apple Cider Vinegar
In addition to unproven benefits, regular vinegar consumption may carry some risks. The high acidity of apple cider vinegar could damage tooth enamel if ingested undiluted in large amounts, says Dr. Edmond R. Hewlett, professor at the UCLA School of Dentistry and consumer advisor to the American Dental Association.
With mindful consumption, however, the damage can be prevented, he notes. A quick spoonful of ACV may produce only a minuscule amount of erosion, yet prolonged exposure to acid – such as habitually sipping from a glass of ACV or other acidic beverage throughout the day – can lead to severe tooth damage.
If you are consuming ACV, it’s important not to brush your teeth immediately afterwards, Hewlett says. Minerals in our saliva help to replace those dissolved out of the enamel from the spoonful of ACV.
“Brushing immediately after an acid exposure can scrub away this acid-softened outer layer, and it is lost forever, unavailable to be repaired by our saliva,” he says. “We should wait one hour before brushing to let our saliva do its job – rehardening our enamel as well as washing away the residual acid so that it doesn’t linger in the mouth.”
Other issues from regular or excessive consumption of cider vinegar have included digestive discomfort, low potassium levels and throat burns.
“We recommend diluting 1 to 2 tablespoons in 8 to 12 ounces of water and drinking with the first bites of a meal,” says Johnston. “This allows the food matrix to mix with the vinegar and reduce the contact of the acid with the lining of the esophagus as it is ingested.” In her research, they have also limited the dosage to 4 tablespoons or less daily per participant.
Vinegar Cooking Ideas
Vinegar – derived from the French “vin aigre,” or sour wine – has been traced back to 5,000 B.C.E. in Babylon. It was not only used in cooking, but for preservation and medicinal purposes.
The active ingredient in apple cider vinegar is acetic acid, which is found in all vinegars. So there’s not anything unique about ACV, although it seems to have the strongest health halo compared to other vinegars.
Vinegar is a major staple of the Mediterranean diet, and there are many ways to enjoy ACV that doesn’t involve drinking a spoonful or chewing gummies. Also check out other vinegars, such as balsamic, white wine, red wine, rice, champagne and sherry vinegar.
It’s good to regularly consume vinegar since it’s the only dietary source of acetic acid, which is converted to acetate once it hits our blood stream. Acetate has been known for decades as important in human metabolism, says Johnston.
Skip bottled salad dressings and make your own simple vinaigrette by whisking together vinegar, Dijon mustard, extra-virgin olive oil, salt and pepper. Use vinegar to make quick pickled vegetables, including pickled red onions that are a tasty addition to salads, sandwiches and bowls. Add vinegars to sauces, glazes and marinades for meat. Make your own switchel – a vinegar-based Colonial-era drink that is enjoying a resurgence as a mocktail. Combine ACV with water, honey or maple syrup, and fresh ginger.
